Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 20;11(3):e2021068.
doi: 10.5826/dpc.1103a68. eCollection 2021 May.

Reflectance Confocal Microscopy of Aging Skin and Skin Cancer

Stefania Guida  1 , Giovanni Pellacani  1 , Silvana Ciardo  1 , Caterina Longo  1   2
Affiliations
Review

Reflectance Confocal Microscopy of Aging Skin and Skin Cancer

Stefania Guida et al. Dermatol Pract Concept. .

Abstract

Skin aging is a complex process that causes morphologic variations. Some of these variations have been hypothesized to be involved in skin cancer development. This paper reviews current knowledge of the features of aged skin as seen with reflectance confocal microscopy (RCM). Basic principles of the technique are described, and the RCM features of healthy skin and skin cancer are briefly discussed. Moreover, the RCM features at different layers of young and elderly skin are described, as are the variations that occur with passing years and in relation to sun exposure that contribute to photoaging and the development of skin cancer. RCM enables the noninvasive evaluation, at quasi-histologic resolution, of aging-related skin changes, some of which are shared with skin cancer; this ability helps avoid skin biopsy. Further research is needed to understand the relation between skin aging and skin cancer development.

Keywords: Skin aging; blood vessels; collagen; reflectance confocal microscopy; skin cancer.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Reflectance confocal micrographs showing morphologic aspects of young skin. (A) Regular honeycomb pattern. (B) Reticular collagen. Scale bars = 100 μm.
Figure 2
Figure 2
Reflectance confocal microscopy appearance of aged skin. (A) Polycyclic papillary contours (green circles). (B) Atypical honeycomb pattern (pink stars). (C) Mottled pigmentation (white arrows). Scale bars = 100 μm.
Figure 3
Figure 3
Reflectance confocal micrographs at dermal level. (A) Reticular collagen, typical of young subjects. (B) Coarse collagen. (B) Huddle collagen. (C) Curled fibers in a subject with solar elastosis (red arrows). Scale bars = 100 μm.
Figure 4
Figure 4
Clinical photograph (A) and dermoscopic image (B) of a pigmented actinic keratosis of the left cheek in a 70-year-old woman. (C) Reflectance confocal micrograph of the area marked by a pink square in B, showing an atypical honeycomb pattern (white squares). (D) Clinical photograph and (E) dermoscopic image of a lentigo maligna on the left cheek of a 64-year-old woman. (F) Reflectance confocal micrograph of the area marked by a green square in E, showing atypical cells (both rounded and dendritic) infiltrating the hair follicle (green arrows). Scale bars = 100 μm.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Longo C, Galimberti M, De Pace B, Pellacani G, Bencini PL. Laser skin rejuvenation: epidermal changes and collagen remodeling evaluated by in vivo confocal microscopy. Lasers Med Sci. 2013;28:769–776. doi: 10.1007/s10103-012-1145-9. - DOI - PubMed
    1. Rovatti PP, Pellacani G, Guida S. Hyperdiluted calcium hydroxylapatite 1: 2 for mid and lower facial skin rejuvenation: efficacy and safety. Dermatol Surg. 2020;46:e112–e117. doi: 10.1097/DSS.0000000000002375. - DOI - PubMed
    1. Yaar M, Gilchrest BA. Photoageing: mechanism, prevention and therapy. Br J Dermatol. 2007;157:874–87. doi: 10.1111/j.1365-2133.2007.08108.x. - DOI - PubMed
    1. Sachs DL, Varani J, Chubb H, et al. Atrophic and hypertrophic photoaging: Clinical, histologic, and molecular features of 2 distinct phenotypes of photoaged skin. J Am Acad Dermatol. 2019;81:480–488. doi: 10.1016/j.jaad.2019.03.081. - DOI - PubMed
    1. Kennedy C, Bajdik CD, Willemze R, et al. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. J Invest Dermatol. 2003;120:1087–1093. doi: 10.1046/j.1523-1747.2003.12246.x. - DOI - PubMed

LinkOut - more resources